The present invention relates to medical examination speculums.
It has been known through a very long history of medical speculums that a broadly spatulated, two bladed device is the standard for performing vaginal examinations. Vaginal speculums typical of the current state of the art are found in the Cooper Surgical Winter 1996 catalog of CooperSurgical Inc. at page 18 and in the Cooper Surgical Spring 1997 catalog of CooperSurgical Inc. at page 29. Two bladed lateral wall retractors typical of the current state of the art are shown in the Cooper Surgical Winter 1996 catalog of CooperSurgical Inc. at page 29.
It is a special object of the present invention to address the function of a combined application of a vaginal speculum and a lateral wall retractor shown Cooper Surgical Winter 1996 catalog of CooperSurgical Inc. at the top illustrations of page 18. In that set of illustrations, it is clear that the combined action of the speculum and retractor present a far more effective view of the cervix. The confused and unstable mass of equipment used to achieve that effect is a disadvantage to the skilled examiner. The combination effect on viewing and cervix manipulation is clearly beneficial over the use of a speculum alone, as shown in the comparative illustrations of page 18, i.e., the vaginal walls do not press into the field of view/field of desirable manipulation for stabilization of the cervix. This combined effect is sometimes critical to conducting an effective examination since uteral positioning through retrocession, anteflexion or retroflexion may require maximum viewing/manipulation exposure of the cervix.
U.S. Pat. No. 5,377,667 discloses a vaginal retractor device with side wall supports in the form of a set of relatively narrow top and bottom blades and two pairs of side-directed arms, all of which are under spring tension in the closed position and which equilaterally expand to an open position upon gradual release of the spring tensioning means. This device comprises several disadvantages. The most serious of these is the lack of independent control of the top blade, a defect seen in most of the improvement devices known in the prior art.
As is seen in the Cooper Surgical catalogs, the vaginal speculums all comprise a top spatulate blade capable of angular movement around a base hinge and position locking means (a threaded shaft and positioning nut). Preserving this function is one of the most important aspects of vaginal examination. The bottom blade is maintained in a substantially fixed position while the top blade is moved upward and downward in order to obtain the most effective "presentation" of the cervix. The device of U.S. Pat. No. 5,377,667 cannot perform this function without equilaterally increasing or decreasing the lateral expansion of all the blades and arms at the same time.
The separate lateral wall retractor and two bladed speculum combination suffer from the following disadvantages. Safe manipulation of the top blade of the speculum requires removal from the vaginal vault the lateral wall retractors. The up and down motion of the top blade may pinch or compress a section of the vaginal wall. Removal of the lateral wall retractor is not a minor action. The retractor is of especially heavy construction to facilitate transmission of hand pressure over a curved set of shafts finally to a set of spatulate blades within the vaginal vault. The retractor is also, according to the prices shown in the Cooper Surgical catalogs, 50% more expensive that the vaginal speculum than the retractor is just supposed to be assisting. In addition, the heavy construction of the lateral wall retractor adds to the mass at the lower outside handle area of the examination devices, an effect that has the tendency to "drag" the speculum/retractor combination out of the vaginal vault by a levering action.
It is an object of the present invention to at least effect the function of the combined speculum/retractor apparatus of Cooper Surgical Winter 1996 catalog of CooperSurgical Inc. at page 18. It is further an object of the present invention to present an effective new expansion motion for at least two lateral expansion blades whose axes remain substantially parallel during a first expansion motion.